Stabilization systems

ABSTRACT

Devices, systems, and methods of bone stabilization. The bone stabilization system includes a variety of plates, including a tine plate. The tine plate may include an elongate body and first and second ears extending from the elongate body, each of the first and second ears defining a screw hole therethrough, and a first tine extending from the first ear and a second tine extending from the second ear, the first and second tines each terminating at a sharp point.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application is a continuation-in-part of U.S. patentapplication Ser. No. 15/893,774, filed Feb. 12, 2018, which is acontinuation-in-part of U.S. patent application Ser. No. 15/405,368filed Jan. 13, 2017, which is a continuation-in-part of U.S. patentapplication Ser. No. 15/238,772, filed Aug. 17, 2016, each of which ishereby incorporated by reference in its entirety for all purposes.

FIELD

The present disclosure relates to surgical devices, and moreparticularly, stabilization systems, for example, for traumaapplications.

BACKGROUND

Bone fractures are often repaired by internal fixation of the bone, suchas diaphyseal or methaphyseal bone, using one or more plates. The plateis held against the fractured bone with screws, for example, whichengage the bone and heads which provide a compressive force against theplate. The plate and bone are thus forced against each other in a mannerthat transfers load primarily between a bone contacting surface of theplate and the bone surface to reinforce the fractured bone duringhealing. This manner of plating generally creates relatively low stressconcentration in the bone, as there may be a large contact area betweenthe plate and the bone surface permitting transfer of load to bedispersed. There may be a desire to use locking screws, non-lockingscrews, or a combination of both that are able to dynamically compressthe bone. Of course, the designs of the plates, types of screws, andlocking and/or non-locking capabilities may vary based on the locationand type of fracture. Thus, there is a need for plating systems thatprovide stabilization to the appropriate anatomical area while providingappropriate locking and/or unlocking capability for dynamic compressionof the bone.

SUMMARY

To meet this and other needs, devices, systems, and methods of bonestabilization are provided. The stabilization systems may include one ormore plates and one or more fasteners. The fasteners may include lockingand/or non-locking bone screws that a surgeon may select based onpreference for a specific anatomical case. The locking fasteners mayconnect to the plate and the bone to thereby lock the plate to the bone.The non-locking fasteners may be able to dynamically compress the boneand create interfragmental compression.

According to one embodiment, a stabilization system includes a boneplate and a fastener. The bone plate has an upper surface and a lowersurface configured to be in contact with bone, the bone plate having anopening extending from the upper surface to the lower surface. Theopening includes a textured portion and non-textured portion, whereinthe textured portion comprises a texture that is a non-threaded surface.The fastener is configured to be received by the opening and configuredto be inserted into the bone. The opening is configured to receiveeither a locking fastener or a compression fastener. The lockingfastener may have a threaded head portion configured to engage thetextured portion and lock to the bone plate, and the compressionfastener may have a substantially smooth head portion configured todynamically compress the bone. The opening may include a combinationcompression and locking through hole formed by a first bore having afirst bore axis and a second bore having a second bore axis differentfrom the first bore axis. In some instances, one of the first and secondbores may have an elongated opening, for example, to allow fortranslation of the non-locking, compression fastener.

According to another embodiment, a stabilization system includes a boneplate, a locking fastener, and a compression fastener. The bone platehas an upper surface and a lower surface configured to be in contactwith bone, the bone plate having an opening extending from the uppersurface to the lower surface, the opening including a textured portionand non-textured portion, wherein the textured portion comprises atexture that is a non-threaded surface. The locking fastener isconfigured to be received by one of the openings and configured to beinserted into the bone, wherein the locking fastener has a threaded headportion configured to lock to the bone plate. The compression fasteneris configured to be received by one of the openings and configured to beinserted into the bone, wherein the compression fastener has asubstantially smooth head portion configured to dynamically compress thebone. Each opening is configured to receive either the locking fasteneror the compression fastener.

According to yet another embodiment, a stabilization system includes abone plate and a fastener. The bone plate has an upper surface and alower surface configured to be in contact with bone, the bone platehaving an opening extending from the upper surface to the lower surface,wherein the opening is formed by at least three different partiallyoverlapping bores including a first bore having at least a partial firstinternal thread, a second bore having at least a partial second internalthread, and a third bore having at least a partial third internalthread. The fastener is configured to be received by the opening andconfigured to be inserted into the bone, wherein the opening isconfigured to receive either a locking fastener or a compressionfastener, the locking fastener having a threaded head portion configuredto lock to the bone plate, and the compression fastener having asubstantially smooth head portion configured to dynamically compress thebone.

According to yet another embodiment, a bone stabilization plate includesan elongate body extending from a first end to a second end and definingat least one screw hole therethrough. A mesh head is connected to thesecond end of the elongate body. The mesh head includes a plurality ofrings, with each of the rings defining a screw hole. Bridge portionsextend between and interconnect the rings. The bridge portions have areduced thickness compared to the rings.

According to another embodiment, a bone stabilization plate includes amesh body. The mesh body includes a plurality of rings, with each of therings defining a screw hole. Bridge portions extend between andinterconnect the rings. The bridge portions have a reduced thicknesscompared to the rings.

According to another embodiment, a bone stabilization plate includes anelongated body extending between first and second ends and having anupper surface and an opposed bone contacting surface. The bonecontacting surface has a scalloped configuration and at least one of theends has a beveled configuration. The body defines a plurality of screwholes and each of the screw holes have the same diameter.

According to yet another embodiment, a bone stabilization plate includesan elongate body extending from a first end to a second end along alongitudinal axis, the elongate body defining at least one screw holetherethrough, first and second ears extending from the second end of theelongate body, each of the first and second ears defining a screw holetherethrough, and a first tine extending from the first ear and a secondtine extending from the second ear, the first and second tines eachterminating at a sharp point.

Also provided are additional stabilization systems, methods forinstalling the stabilization systems, and kits including bone plates,fasteners, and components for installing the same.

BRIEF DESCRIPTION OF THE DRAWING

A more complete understanding of the present invention, and theattendant advantages and features thereof, will be more readilyunderstood by reference to the following detailed description whenconsidered in conjunction with the accompanying drawings wherein:

FIG. 1 depicts a top perspective view of a diaphyseal bone plateaccording to one embodiment;

FIG. 2 depicts a bottom perspective view of the plate of FIG. 1;

FIG. 3 is a close-up view of a combination hole according to oneembodiment;

FIG. 4 shows the head of the fastener engaged with a portion of thecombination hole;

FIG. 5 is a top perspective view of two fasteners engaged with the twocombination holes;

FIG. 6 is a close-up perspective view of the fastener head beforeengaging the textured portion of the combination hole;

FIG. 7 is a close-up view of an alternative version of a combinationhole according to another embodiment;

FIG. 8 is a perspective view of a fastener inserted through thecombination hole of FIG. 7;

FIG. 9 is a perspective view of two fastener inserted through thecombination holes of FIG. 7;

FIGS. 10A-10C show a perspective view, top view, and cross-section view,respectively, of an another embodiment of a combination hole;

FIGS. 11A-11C show a perspective view, top view, and cross-section view,respectively, of an another embodiment of a combination hole;

FIGS. 12A-12C show a perspective view, top view, and cross-section view,respectively, of an another embodiment of a hole for receiving afastener;

FIGS. 13A-13C show a perspective view, top view, and cross-section view,respectively, of an another embodiment of a combination hole;

FIGS. 14A-14C show a perspective view, top view, and cross-section view,respectively, of an another embodiment of separate locking andnon-locking holes;

FIGS. 15A-15C show a perspective view, top view, and cross-section view,respectively, of one embodiment of a plate including the separatelocking and non-locking holes;

FIGS. 16A-16C show a perspective view, top view, and cross-section view,respectively, of another embodiment of a plate including the separatelocking and non-locking holes;

FIGS. 17A-17D show a perspective view, a top view, a cross-section view,and a perspective view with a locking fastener, respectively, accordingto another embodiment of a plate including three overlapping locking andnon-locking holes;

FIGS. 18A-18B show perspective views of a plate according to anotherembodiment with locking and non-locking functionality;

FIGS. 19A-19E shows alternative locking screw and openings in platesaccording to yet another embodiment;

FIGS. 20A-20B show a self-drilling screw according to anotherembodiment;

FIGS. 21A and 21B depict a fastener according to another embodiment withself-forming threads configured to form threads in the opening of aplate;

FIGS. 22A and 22B depict an opening in a plate according to oneembodiment having a windswept cut configured to receive the self-formingthreads of the fastener of FIGS. 21A-21B;

FIGS. 23A and 23B depict an opening in a plate according to anotherembodiment having a knurled cut configured to receive the self-formingthreads of the fastener of FIGS. 21A-21B;

FIGS. 24A and 24B depict an opening in a plate according to anotherembodiment having a polygonal cut configured to receive the self-formingthreads of the fastener of FIGS. 21A-21B; and

FIG. 25A depicts an alternative opening in a plate according to anotherembodiment;

FIG. 25B depicts another alternative opening in a plate according to yetanother embodiment;

FIGS. 26A-26D depict a plate assembly according to one embodiment wherea locking or non-locking fastener may be positioned at an angle orperpendicular to the plate;

FIGS. 27A-27E depict a non-locking fastener with a dynamic compressionslot in a plate according to one embodiment;

FIGS. 28A-28E show alternative fastener types and a stacked holeconfiguration in a plate according to another embodiment;

FIGS. 29A-29J show embodiments of straight plates and alternative holeconfigurations including dynamic compression slots; stacked holes and/orcombination holes;

FIGS. 30A-30I depict alternative embodiments of reconstruction plateswith alternative hole patterns;

FIGS. 31A-31G show embodiments of T-plates with alternative holearrangements;

FIGS. 32A-32B show an embodiment of an illustrative Y-plate;

FIGS. 33A-33B show an embodiment of an illustrative condylar plate;

FIGS. 34A-34B show an embodiment of an illustrative X-plate;

FIGS. 35A-35B show an embodiment of an illustrative cluster plate;

FIGS. 36A-36B show embodiments of illustrative mesh plates;

FIGS. 37A-37D relate to cloverleaf plates with alternative holeconfigurations.

FIGS. 38A-38B show an embodiment of an alternative T-plate;

FIGS. 39A-39B show an embodiment of a tine plate;

FIGS. 40A-40H show alternative embodiments of plates having differentgeometrical configurations; and

FIGS. 41A-41B show an alternative embodiment of a trauma plate which maybe suitable, for example, for miniature bone fragments.

DETAILED DESCRIPTION

Embodiments of the disclosure are generally directed to devices,systems, and methods for bone stabilization. Specifically, embodimentsare directed to bone plating with locking and/or non-locking fastenersfor dynamic compression of the bone. The hole designs may allow forfixed angle and/or polyaxial locking and/or non-locking of thefasteners. Some embodiments include blocking fasteners to prevent thebone fastener from backing out. Some embodiments further include lockingfasteners with self-forming threads configured to displace the platematerial, thereby locking the fastener to the plate.

The plates may be adapted to contact one or more of a femur, a distaltibia, a proximal tibia, a proximal humerus, a distal humerus, aclavicle, a fibula, an ulna, a radius, bones of the foot, bones of thehand, or other suitable bone or bones. The bone plate may be curved,contoured, straight, or flat. The plate may have a head portion that iscontoured to match a particular bone surface, such as a metaphysis ordiaphysis, flares out from the shaft portion, forms an L-shape, T-shape,Y-shape, etc., with the shaft portion, or that forms any otherappropriate shape to fit the anatomy of the bone to be treated. Theplates may be adapted to secure small or large bone fragments, single ormultiple bone fragments, or otherwise secure one or more fractures. Inparticular, the systems may include a series of trauma plates and screwsdesigned for the fixation of fractures and fragments in diaphyseal andmetaphyseal bone. Different bone plates may be used to treat varioustypes and locations of fractures.

The bone plate may be comprised of titanium, stainless steel, cobaltchrome, carbon composite, plastic or polymer—such aspolyetheretherketone (PEEK), polyethylene, ultra high molecular weightpolyethylene (UHMWPE), resorbable polylactic acid (PLA), polyglycolicacid (PGA), combinations or alloys of such materials or any otherappropriate material that has sufficient strength to be secured to andhold bone, while also having sufficient biocompatibility to be implantedinto a body. Similarly, the fasteners may be comprised of titanium,cobalt chrome, cobalt-chrome-molybdenum, stainless steel, tungstencarbide, combinations or alloys of such materials or other appropriatebiocompatible materials. Although the above list of materials includesmany typical materials out of which bone plates and fasteners are made,it should be understood that bone plates and fasteners comprised of anyappropriate material are contemplated.

The embodiments of the disclosure and the various features andadvantageous details thereof are explained more fully with reference tothe non-limiting embodiments and examples that are described and/orillustrated in the accompanying drawings and detailed in the followingdescription. The features of one embodiment may be employed with otherembodiments as the skilled artisan would recognize, even if notexplicitly stated herein. Descriptions of well-known components andprocessing techniques may be omitted so as to not unnecessarily obscurethe embodiments of the disclosure. The examples used herein are intendedmerely to facilitate an understanding of ways in which the disclosuremay be practiced and to further enable those of skill in the art topractice the embodiments of the disclosure. Accordingly, the examplesand embodiments herein should not be construed as limiting the scope ofthe disclosure, which is defined solely by the appended claims andapplicable law. Moreover, it is noted that like reference numeralsrepresent similar features and structures throughout the several viewsof the drawings.

Referring now to the drawing, FIGS. 1-9 depict one embodiment of a plate10 including one or more openings 20. The openings 20 extending throughthe plate 10 are configured to accept locking fasteners 30, non-lockingfasteners 40, or a combination of both locking and non-locking fasteners30, 40 that are able to dynamically compress the bone and/or affix theplate 10 to the bone. When plating diaphyseal bone, surgeons may use acombination of both locking and non-locking fasteners 30, 40 that areable to dynamically compress bone and to connect the bone and the plate10. Dynamic compression may also be desirable to create interfragmentalcompression while tightening the fasteners 30, 40.

As shown in FIGS. 1 and 2, the plate 10 has a body that extends from afirst end 12 to a second end 14 along a central longitudinal axis A. Theplate 10 includes a top surface 16 and an opposite, bottom surface 18configured to contact adjacent bone. The top and bottom surfaces 16, 18are connected by opposite side surfaces extending from the first tosecond ends 12, 14 of the plate 10. Although the plate 10 is shownhaving a generally longitudinal body, it will be appreciated that anysuitable shape and contouring of the plate 10 may be provided dependingon the location and type of fracture to be plated.

The plate 10 includes one or more through openings 20 configured toreceive one or more bone fasteners 30, 40. The openings 20 extendthrough the body of the plate 10 from the top surface 16 to the bottomsurface 18. Each of the openings 20 may be in the form of a combinationopening that has at least two overlapping holes. As shown in FIG. 1, thecombination opening 20 includes a first hole 22 overlapping a secondhole 24. One of the holes 22 may be configured to be the locking hole22, thereby able to receive and secure the locking fastener 30 to theplate 10, and the other of the holes 24 may be configured to be thedynamic compression hole 24, thereby allowing the non-locking fastener40 to freely move in the hole 24 and apply dynamic compression. Thelocking hole 22 may have one or more locking features designed to engagewith a locking fastener 30, and the dynamic compression hole 24 may beelongated, for example, along the central longitudinal axis A of theplate 10. The screw holes 22, 24 are not constrained to parallel axes.This hole geometry may be used in bone plates 10 to utilize either fixedangle or variable angle locking screws 30 and/or polyaxial non-lockingscrews 40 that can achieve dynamic compression.

The plate 10 may comprise any suitable number of openings 20 in anysuitable configuration. As shown, the plate 10 is a generally anelongate plate 10 including six combination openings 20 positioned alongthe central longitudinal axis A of the plate 10. The combinationopenings 20 may also be oriented in any suitable orientation such thatthe locking holes 22 and dynamic compression holes 24 are optimizedbased on the type and location of the fracture. As shown, starting fromthe second end 14 of the plate 10, three of the combination openings 20are aligned such that the dynamic compression holes 24 are positionedtoward the second end 14, and the three combination openings 20 past themidline of the plate 10, are reversed and aligned such that the dynamiccompression holes 24 are now positioned toward the first end 12 of theplate.

These openings 20 allow surgeons more flexibility for fastenerplacement, based on preference, anatomy, and fracture location. Surgeonsmay have differing opinions as to whether non-locking or locking screws30, 40 (or some combination of the two) should be used in diaphysealbone. Further, complexity of fracture location and shape makes having asmany locations for fasteners 30, 40 as possible necessary. This designoffers surgeons a versatile method to achieve higher accuracy inplacement of locking and/or non-locking screws 30, 40.

As best seen in FIGS. 4-6, the locking and non-locking fasteners 30, 40are shown. The locking and non-locking fasteners 30, 40 may includetraditional fasteners known in the art. The locking and non-lockingfasteners 30, 40 may comprise bone screws or the like. The fasteners 30,40 may also include other fasteners or anchors configured to be securedor engaged with bone, such as nails, spikes, staples, pegs, barbs,hooks, or the like. The fasteners 30, 40 may include fixed and/orvariable angle bone screws.

The locking fastener 30 may include a head portion 32 and a shaftportion 34 configured to engage bone. The shaft portion 34 may bethreaded such that the fastener 30 may be threaded into the bone. Thehead portion 32 of the locking fastener 30 includes a textured area 36around its outer surface sized and configured to engage with the lockinghole 22 of the combination opening 20. The textured area 36 may includethreads, ridges, bumps, dimples, serrations, or other types of texturedareas. As shown, the texture area 36 preferably includes a threadedportion extending substantially from the top of the head portion 32 tothe bottom of the head portion 32 proximate to the shaft portion 34.Thus, when the textured area 36 engages the locking hole 22, the lockingfastener 30 is thereby locked to the plate 10.

The non-locking fastener 40 includes a head portion 42 and a shaftportion 44 configured to engage bone. The shaft portion 44 may bethreaded such that the fastener 40 may be threaded into the bone. Thehead portion 42 of the non-locking fastener 40 is substantially smootharound its outer surface such that is able to slide along the elongatedcompression hole 24. Thus, the non-locking fastener 30 may be coupled tothe plate 10, but not locked thereto to enable dynamic compression ofthe bone. It will be recognized that the head portions 32, 42 of thefasteners 30, 40 may include a recess configured to receive a driver orthe like.

As best seen in FIGS. 2 and 4, the locking hole portion 22 of thecombination opening 20 includes a textured portion 26. The texturedportion 26 may include threads, ridges, bumps, dimples, serrations,knurls, or other types of textured areas. The textured portion 26 may beof the same type (e.g., mating surfaces) or different from the texturedarea 36 of the locking fastener 30. As shown, the textured portion 26 isserrated or knurled along an inner portion of the hole 22. The knurledsurface may include straight, angled, or crossed lines cut or rolledinto the material. In the embodiment shown in FIG. 1-6, the texturedportion 26 extends along substantially the entire inner surface of thehole 22. With reference to the embodiment shown in FIGS. 7-9, thecombination hole 20 is substantially the same as that shown in FIGS. 1-6except that the textured portion 26 the locking hole 22 now includes athin centralized textured ribbon of material. For example, the texturedportion 26 takes up about half or less of the surface area of the hole22. In this instance, only a portion of the textured area 36 of the headportion 32 of the locking fastener 30 engages with and locks to thetextured portion 26 of the hole 22.

An upper portion of the hole 22 may be tapered 28, without texturing,for example, to facilitate alignment of the fastener 30 with the opening20. As shown in FIGS. 6-8, this tapered portion 28 is enlarged in arearelative to the embodiment in FIGS. 1-5. The hole 22 may be configuredto receive a fixed or variable angle fastener 30. The hole 22 may begenerally conical in shape such that it is wider near the top surface 16of the plate 10 and narrower toward the bottom surface 18 of the plate10. The tapered portion 28 and/or the textured area 26 may be conical inshape. In this embodiment, the locking hole 22 is a textured fixed angleconical hole configured to receive locking fastener 30. The texturedholes 22 may deform as the fastener head 32 interferes with the texturedportion 26 of the hole 22, thereby providing a positive lock between thefastener 30 and the plate 10.

The second hole portion 24 of the combination opening 20 may be anelongated dynamic compression hole. The dynamic compression hole 24 maybe elongated such that it has a length greater than its width. The hole24 may be elongated along the longitudinal axis A of the plate 10. Inthe alternative, the hole 24 may be generally cylindrical such that thehole 24 only permits polyaxial movement of the fastener 40. The innersurface of the hole 24 may be substantially smooth such that thenon-locking fastener 40 is able to freely pivot and/or slide along theelongated hole 24. This provides for at least two directions ofcompressive force (e.g., along the longitudinal axis A and perpendicularto the longitudinal axis A). The head portion 42 of the non-lockingfastener 40 may be substantially smooth around its outer surface. Thehead portion 42 is sized and configured to engage with and be retainedwithin the hole portion 24 of the combination opening 20. The hole 24may be configured to receive a fixed or variable angle fastener 40. Inone embodiment, the hole 24 may be generally conical in shape and/ortapered such that it is wider near the top surface 16 of the plate 10and narrower toward the bottom surface 18 of the plate 10. In thisembodiment, the hole 24 is a smooth variable angle conical holeconfigured to receive the non-locking fastener 40. The hole 24 mayreceive the fastener head 42 allowing movement of the fastener 40, forexample, in a polyaxial fashion and/or along the length of the hole 22,thereby providing dynamic compression of the bone.

The plate 10 may have one or more additional features. For example, theplate 10 may include one or more through holes 50 extending through theplate 10. For example, holes 50 may extend from the top surface 16 tothe bottom surface 18 of the plate 10. These holes 50 may be configuredto receive k-wires (not shown). In the embodiment shown, six holes 50are provided along the central longitudinal axis A of the plate 10 toreceive one or more k-wires. Although it will be appreciated that anynumber and location of holes 50 may be provided for receiving k-wires.The plate 10 may also include one or more reliefs to minimize contact ofthe plate 10 with the bone and preserve the anatomy. For example, therelief may be in the form of one or more conical cuts 52 along thebottom surface 18 of the plate 10. The conical cuts 52 may be positionedon either side of the k-wire holes 50 and extend outward towards theside surfaces of the plate 10. Each conical cut 52 may include anarrowed portion proximate to the k-wire hole 50 (e.g., along thecentral longitudinal axis A of the plate 10) and a widened portionproximate to the outer side surfaces. Although twelve conical cuts 52are provided around the six k-wire holes 50, it is envisioned that theconical cuts 52 may be provided at any suitable location and number aswould be recognized by one of skill in the art. The plate 10 may furtherinclude one or more perimeter reliefs 54 extending around the bottomsurface 18 of the plate 10 to reduce unnecessary contact with bone as ananatomy preserving measure. As shown, the perimeter relief 54 is acutout in the bottom surface 18 of the plate 10 which extends around theouter perimeter of the plate 10. The perimeter relief 54 is interruptedby each of the conical cuts 52. The perimeter relief 54 generally leavesan outer edge surface (e.g., around the sides and first and second ends12, 14 of the plate 10) except where interrupted by the conical cuts 52and a central portion of the bottom surface raised relative to therelief 54. The width and depth of the relief 54 may be of any suitabledimension to provide adequate contact between the plate 10 and the bonewhile minimizing unnecessary contact to preserve the anatomy.

Turning now to FIGS. 10-18, alternative types of openings 20A-20G, whichprovide for locking and/or non-locking, dynamic compression, and thelike, are provided. Although only the holes are exemplified in thesefigures, it will be appreciated that the plate 10 may be of any suitablesize, shape, and dimension depending on the plating application. As manyof the features of these openings are similar to the combinationopenings 20 described already for FIGS. 1-9, only the different featureswill be further explained.

With reference to FIGS. 10A-10C, the combination opening 20A is similarto combination opening 20 except that the dynamic compression hole 24Ahas the same general diameter as the locking hole 22A, and the lockinghole 22A includes a different type of textured portion 26A. In thisembodiment, the locking hole 22A has a first diameter D1, and thedynamic compression hole 24A has a second diameter D2. Unlike theelongated hole 24 described earlier, dynamic compression hole 24A hassubstantially same diameter as the locking hole 22A. Thus, the first andsecond diameters D1, D2 are substantially the same. The hole 24A may beformed by milling or drilling a sphere out of the plate 10 in the centerof the circle with tapers or ramps on either side. The hole 24A is notelongated, but is generally circular and the non-locking fastener 40will be allowed to translate in the hole 24A because the diameter of thehead portion 42 and/or shaft (e.g., bone thread) will be smaller thanthe size of the hole 24A in the plate 10. With respect to hole 22A, thetextured portion 26A of the hole 22A may be in the form of a taperedthread. This tapered thread may generally correspond to a similartapered thread on the locking fastener 30. This hole 22A also does notinclude a tapered portion, and the textured portion 26A begins at theintersection with the top surface 16 of the plate 10. This alternativeopening 20A also provides for the use of both locking and non-lockingfasteners 30, 40 that are able to dynamically compress bone and/or lockthe plate 10 to the bone.

Turning now to FIGS. 11A-11C, the combination opening 20B is similar toother combination openings except that the locking hole 22B includes adifferent type of textured portion 26B. The textured portion 26Bincludes a series of alternating recesses and protrusions around acentral portion of the hole 22B. The recesses may be in form of a waveof alternating cutouts extending around the inner perimeter of the hole22B. The textured portion 26B may lock the fastener 30 with a frictionfit or may be modified during insertion of the fastener 30 to form alock in situ. In this embodiment, the locking hole may allow forpolyaxial locking. The plate 10 and the locking fastener 30 may be madeof dissimilar materials having dissimilar hardness values. For example,the fastener 30 may have a higher hardness (e.g., on the Rockwell scale)relative to the plate 10, which may be formed of a material having alower relative hardness value. Due to the increased hardness, the headportion 32 of the locking fastener 30 may create a thread in the plate10 as the fastener 30 is inserted (e.g., threaded) into the hole 22B,thereby locking the fastener 30 to the plate 10.

With reference to FIGS. 12A-12C, the opening 20C includes locking hole22C and dynamic compression hole 24C with a more open configuration. Thelocking portion 22C has a textured portion 26C in the form of a taperedthread. This tapered thread may generally correspond to a similartapered thread on the locking fastener 30. The opposite portion 24C ofthe opening 20C is oblong with a ramp 25C milled into the top surface 16of the plate 10 to allow for dynamic compression. As best seen in FIG.12C, the ramp may be partially spherical in shape and extend from thetop surface 16 of the plate 10 and connect to the textured portion 26C.When viewed from above in FIG. 12B, the ramp 25C creates a square-like,key-hole, and/or non-hole geometry that sweeps into the tapered threadedlocking hole 22C. This alternative opening 20C also provides for the useof both locking and non-locking fasteners 30, 40 that are able todynamically compress bone and/or lock the plate 10 to the bone.

Turning now to FIGS. 13A-13C, the opening 20D includes locking hole 22Dand dynamic compression hole 24D. These holes 22D, 24D are connected andclose together but are not overlapping. The holes 22D, 24D are separatedby a small portion or sliver of plate material proximate to the lowerportion of the holes 22D, 24D (e.g., at bottom surface 18 of the plate10 and partially extending between the holes 22D, 24D). The lockingportion 22D has a textured portion 26D in the form of a tapered thread.The textured portion 26D extends around almost the entire circumferenceof the hole 22D except where connected to hole 24D. The dynamiccompression hole 24D is elongated and has ramped portions 25D onopposite sides of the hole 24D to receive fastener 40. Thisconfiguration allows for a very close population of holes 22D, 24D onthe plate 10 while giving structural stability at the holes 22D, 24D.

With reference to FIGS. 14A-14C, locking hole 22E and dynamiccompression hole 24E are adjacent, but separate from one another. Theholes 22E, 24E are completely separated from one another by a wall 56 ofplate material. The locking portion 22E has a textured portion 26E inthe form of a tapered thread extends around the entire perimeter of thehole 22E. The dynamic compression hole 24E is elongated and has rampedportions 25E on opposite sides of the hole 24E. This configuration alsoallows for a very close population of holes 22E, 24E on the plate 10while giving options for both locking and/or dynamic compression.

FIGS. 15A-15C and 16A-16C show alternative arrangements of locking holes22E and dynamic compression holes 24E on plate 10. As shown in FIGS.15A-15C, the locking and non-locking holes 22E, 24E are staggered overthe length of the plate 10. A first series of locking holes 22E arearranged in a first line along the length of the plate 10, and a secondseries of non-locking holes 24E are arrange in a second line along thelength of the plate 10. The first line of holes 22E are offset relativeto the second line of holes 24E such that every other hole will benon-locking or locking. Although depicted in straight lines, it iscontemplated that the holes 22E, 24E may not necessarily be arranged ina straight line. In FIGS. 16A-16C, the locking and non-locking holes22E, 24E are staggered along the length of the plate 10 such that eachhole alternates between a locking hole 22E and a non-locking hole 24E.The holes 22E, 24E are generally aligned along the central longitudinalaxis of the plate 10, but it will be appreciated that the holes may beoffset or aligned in any suitable number and configuration along theplate 10.

Turning now to FIGS. 17A-17D, an alternative version of opening 20F isprovided. In this embodiment, the hole construct 20F is comprised of atleast three overlapping conical threaded holes in the plate 10. Theopening 20F includes a first, locking hole 22F, a second hole 24F, and athird hole 23F arranged along a longitudinal axis of the plate 10. Thethird hole 23F is the mirror image of hole 24F across the first lockinghole 22F. The conically threaded holes 22F, 23F, 24F may or may not haveparallel axes. Each hole 22F, 23F, 24F may include a textured portion26F, for example, in the form of one or more threaded portions. Thus,the locking fastener 30 may lock to any of the holes 22F, 23F, 24F.Although each of the holes 22F, 23F, 24F are shown in with the texturedportion 26F, it will be appreciated that one or more of the holes 22F,23F, 24F may have a substantially smooth inner portion instead of thetextured portion 26F. The upper part of the hole construct at the firstand second ends of the hole 20F each have a ramped feature 25F (e.g.,adjacent to holes 23F and 24F) to allow for dynamic compression of theplate 10. In addition, the ramped feature 25F may span the three or moreconical holes 22F, 23F, 24F (e.g., around the entire perimeter of theopening 20F).

The non-locking compression fasteners 40 may have a major bone threaddiameter such that the fastener 40 can translate between overlappingholes 22F, 24F, 23F without interference. As best seen in FIG. 17D, thelocking fastener 30 may include a textured area 36, for example, in theform of a thread, configured to engage with the textured portion 26F ofany of the holes 22F, 23F, 24F. The hole geometry of opening 20F can beapplied to bone plates 10 to utilize either fixed angle and/or variableangle locking screws 30 and/or polyaxial non-locking screws 40 that canachieve dynamic compression. This allows surgeons more flexibility forscrew placement, based on preference, anatomy, and fracture location.

Turning now to FIGS. 18A-18B, another embodiment of opening 20G isprovided. This opening 20G may be comprised of one elongate hole or slotextending from the top surface 16 to the bottom surface 18 of the plate10. A locking portion 22G of the opening 20G may include a texturedportion 26G having straight machine threads. The threads may extend morethan 180 degrees to retain the locking fastener 30. A non-lockingportion 24G of the opening 20G may be positioned opposite the lockingportion 22G to complete the opening 20G. The upper part of the opening20G may have one or more ramped features 25G to allow for dynamiccompression of the plate 10. The ramp 25G may span along the entireupper perimeter of the elongated slot 20G or a portion thereof. Thecompression screws 40 may have a major bone thread diameter such thatthe screws 40 are able to translate along the opening 20G withoutinterference.

With reference to FIGS. 19A-19E, alternative embodiments of the lockingfastener 30 may be used with any plate 10. The head portion 32 of thefastener 30 may include a textured area 36 in the form of a thread, forexample, to lock the fastener 30 to the plate 10. The fastener 30 and/orplate 10 may also include one or more mechanisms to prevent back out ofthe fastener 30 from the plate 10. In FIG. 19A, the head portion 32includes at threaded portion 36A (e.g., having straight threads) thatinterface with the plate 10 and the top of the head extends larger thanthe threads. The head portion 32 bottoms out when the fastener 30 isfully inserted and creates preload in the fastener 30, thus locking thefastener 30 rotationally. In FIG. 19B, the head portion 32 includesthreaded portion 36B. The head portion 32 has a constant major diameterwhile the minor diameter is tapered. The thread depth may go to zero atthe top of the head portion 32 of the screw 30. The first few turnssmoothly insert, but as the tapered portion of the male thread engageswith the plate 10, interference occurs, jamming and/or locking the screw30 and preventing backout. In FIG. 19C, a screw thread 36C on the headportion 32, similar to the design in FIG. 19B, except the minor diameterof the screw 30 stays constant while the major diameter of the headportion 32 gets larger toward the top of the screw 30. A similar jammingand locking mechanism results through tightening of the screw 30 in theplate 10. In FIG. 19D, the threaded portion 36D has areas of varyingpitch. In particular, a straight screw thread on the head portion 32 ofthe screw 30 has a similar pitch to that of the plate 10 at the bottomof the head portion 32 of the screw 30. The pitch then increases ordecreases towards the top of the head portion 32, which thereby resultsin jamming of the threads and preventing unwanted backout of the screw30. In an alternative variation of the concept of FIG. 19D, shown inFIG. 19E, the opening in the plate 10 is provided with areas of varyingpitch while the pitch of the threaded portion 36D remains constant. Forexample, the head portion 32 may include a straight thread with aconstant pitch. The upper surface of the plate 10 may include a threadpitch is similar to that of the screw 30, but towards the bottom surfaceof the plate 10, the thread pitch would either increase or decrease tolock the screw 30 to the plate 10.

Turning now to FIGS. 20A and 20B, a self-drilling fastener 70, which maybe utilized with any of the plates described herein, will be described.The self-drilling fastener 70 includes a head portion 71 and a shaftportion 74 configured to engage bone. The shaft portion 74 includesthreads such that the fastener 70 may be threaded into the bone. Theshaft portion 74 also includes a pointed tip 76 with cutting flutes 78.The pointed tip 76 and cutting flutes 78 allow the self-drillingfastener 70 to be inserted without a pre-drilled hole in the bone,thereby streamlining the insertion step. The head portion 71 of theself-drilling fastener 70 is substantially smooth around its outersurface such that it operates in a manner similar to the non-lockingfasteners 40. It will be recognized that the head portion 71 of thefastener 70 may include a recess configured to receive a driver or thelike. The self-drilling fasteners 70 may be manufactured from variousmaterials, for example, stainless steel, titanium alloy, and cobaltchrome.

In FIGS. 21A-21B, the locking fastener 30 includes a head portion 32 anda shaft portion 34 configured to engage bone. Although not shown, theshaft portion 34 may be threaded such that the fastener 30 may bethreaded into the bone. The head portion 32 may be tapered (e.g., at anangle of about 20°) such that the fit within the opening 20 in the plate10 becomes tighter as the fastener 30 is advanced in to the bone. Thehead portion 32 of the locking fastener 30 includes a textured area 36around its outer surface sized and configured to engage an opening 20 inthe plate 10. The textured area 36 may include threads, ridges, bumps,dimples, serrations, or other types of textured areas. As shown, thetextured area 36 preferably includes a threaded portion extendingsubstantially from the top of the head portion 32 to the bottom of thehead portion 32 proximate to the shaft portion 34. The threads 36 mayrun generally perpendicular to the conical surface of the head portion32. The threaded portion 36 is in the form of self-forming threadsconfigured to displace the plate material and create threads in theopening 20 of the plate 10. The threaded portion has an exaggeratedsharp thread peak to facilitate cutting or forming of the platematerial.

Turning now to FIGS. 22A-25B, alternative versions of the openings 20are shown before being tapped with the fastener 30. Once the fastener 30is inserted, these openings 20 are modified based on the self-formingthreads. The geometry of the openings 20 are conducive to catching thethreads 36 and designed to reduce the axial force necessary to initiatethe thread formation. An upper portion of the hole 20 may be tapered 28,for example, with a conical straight tapered surface cut through the topsurface 16 of the plate 10 for clearance of the head portion 32 of thefastener 30 during off angle insertion. A lower portion of hole 20 mayfurther be tapered 29, for example, with a conical straight taperedsurface cut through the bottom surface 18 of the plate 10 for clearanceof the shaft portion 34 during off angle insertion. The upper taperedportion 28 may be larger, for example, with a larger degree of taperthan the lower tapered portion 29. For example, the upper taperedportion 28 may have a taper in a range from about 60-90°, 70-80°, or72-78°, preferably about 70°, 75°, or 80° whereas the lower taperedportion 29 may have a taper in a range from about 50-70°, 55-65°, or57-63°, preferably about 55°, 60°, or 65°. The upper and/or loweredtapered portions 28, 29 may be substantially conical (e.g., FIGS. 22B,23B, 24B) or may be segmented with more than one section, such as twoseparate conical sections having different diameters or degrees of taper(e.g., FIGS. 25A and 25B).

At the intersection between the upper tapered portion 28 and the lowertapered portion 29 a narrowed central portion may have a texturedportion 26. As described herein, the textured portion 26 may includethreads, ridges, bumps, dimples, serrations, or other types of texturedareas. In the embodiment shown in FIGS. 22A-22B, the textured portion 26includes a windswept cut design comprised of a plurality of shallow cutswhere each cut overlaps the next. For example, the windswept design mayinclude a plurality of threadlike helical cut sweeps. Each cut has asmooth transition into the inner diameter of the hole 20 (e.g., into theupper and lower tapered portions 28, 29). The windswept cuts provide apositive surface for the self-forming threads to cut into, therebyhelping to prevent peeling of the newly formed threads into the plate10.

In FIGS. 23A-23B, the textured portion 26 includes a knurled cut design.A rounded transition between the upper tapered portion 28 and the lowertapered portion 29 (e.g., the two conical cuts) provides a workablesurface for the knurling process as well as a surface for the headportion 32 to be able to roll over during off-axis locking. The knurleddesign may include a plurality of shallow knurled grooves set in adiamond pattern (e.g., about 45°) where each cut overlaps the next. Theknurled grooves allow for the self-forming threads to cut more deeplyinto the material and reduce the necessary axial force to begin thethread forming process. FIGS. 24A-24B depict a polygon form cut design.In this design, there is no textured portion at the transition betweenthe upper tapered portion 28 and the lower tapered portion 29. Instead,the narrowed central region has an overall polygonal form such that thehole 20 is neither cylindrical nor conical. The polygonal shape includesa number of sides with distinct linear section of material and roundedcorners around which the form cut is allowed to sweep. For example, thepolygonal shape may be substantially hexagonal (6-sided), heptagonal(7-sided), octagonal (8-sided), etc. The hole 20 may also be representedwithout lobe cuts, as a single concentric ring with the same geometry.

In FIG. 25A, the upper tapered portion 28 includes a conical straighttapered surface cut for clearance of the head portion 32 of the fastener30 during off angle insertion. The upper tapered portion 28 is segmentedto have an upper area with a larger area relative to a lower areaproximate the transition to the lower tapered portion 29 having anarrower diameter. The central area between the upper and lower taperedportions 28, 29, where the thread forming process occurs, includes twopeaks or concentric rings of material (e.g., a superficial ring 60 and adeep ring 62) with a groove 27 being locating in between for materialremoval and thread forming relief. The groove 27 between the rings 60,62 may be angled, for example, in the range of about 40-80°, about50-70°, or about 60°. The superficial ring 60 is of a slightly smallerinner diameter than the deep ring 62, as the superficial ring 60 isresponsible for supporting a majority of the cantilever loads. The deepring 62 provides additional fixation and support during off-angleinsertion as well as additional support during nominal trajectoryinsertion. The lower tapered portion 29 includes a straight taperedsurface that provides clearance for the shaft 34 of the fastener 30 wheninserted off angle.

The embodiment of the opening 20 in FIG. 25B is similar to FIG. 25A, butfurther includes textured portion 26 in the form of a plurality ofhelical swept cuts at the transition between the upper tapered portion28 and the lower tapered portion 29. The shallow helical cuts orwindswept cuts may include a series of cuts at a steep pitch. Thewindswept cuts may be angled, for example, at about 50-70°, or about60°. The same number of cuts may be made in both a clockwise andcounter-clockwise fashion. The cuts may create plateaus of materialprotruding into the opening 20. The resultant geometry provides positivesurfaces for the fastener 30 to cut into, which can dramatically reducethe axial force necessary to lock the fastener 30 to the plate 10. Thusmechanism does not need to rely on bone purchase in order to engage thethreads in the head portion 32 of the fastener 30. The material removedduring insertion of the fastener 30 allows the self-forming threads tocut deeper by removing material which much be formed and reducingfriction between the fastener 30 and the plate 10 during the formingprocess.

FIGS. 26A-26D depict a screw-plate assembly. The assembly, in FIG. 26C,shows the locking fastener 30 placed at an angle, other thanperpendicular, to the upper surface 16 of the plate 10. In FIG. 26D, anon-locking fastener 40 is placed generally perpendicular to the plate10. It will be appreciated that the locking fastener 30 and non-lockingfastener 40 may be oriented at any appropriate angle relative to theplate 10. The section view in FIG. 26C shows the thread engagement withthe plate 10 in which material of the plate 10 is displaced around thethreads of the fastener 30. By using the self-forming threads, thefastener 30 is able to be inserted into the plate 10 at variable anglesand engages with the plate 10 with one-step locking requiring noadditional steps to lock the fastener 30 to the plate 10. The sectionview in FIG. 26D show the compressive, non-locking screw 40 received inthe opening 20, without threadedly locking thereto. The non-lockingscrew 40 may provide for dynamic compression of the bone. Accordingly,the fasteners and openings described herein provide a wide variety ofoptions for the surgeon, thereby providing appropriate locking and/orunlocking capability for dynamic compression depending on the desiredtreatment of the fracture and the bone.

Turning now to FIGS. 27A-35D, a series of trauma plates 10 and screws30, 40 are shown which are configured for the fixation of fractures andfragments in diaphyseal and metaphyseal bone, for example. The differentbone plates 10 and fasteners 30, 40 may be used in the treatment ofvarious fractures.

FIGS. 27A-29J depict embodiments of straight plate offerings, which maybe provided in a variety of lengths along with a variety of hole optionsand patterns. Additional features on these plates 10 may include k-wireholes 50, limiting contact undercut features 52, and/or tapered plateends 12, 14.

FIGS. 27A-27E show an embodiment of a plate 10 with a dynamiccompression plating (DCP) slot or elongated opening 20I. The DCP slot20I allows motion of the plate 10 relative to the bone 2, 6. Forexample, a fracture 4 may separate bone into two bone fragments 2, 6,respectively. In order to move the bone fragments 2, 6 towards oneanother and minimize the fracture 4, plate 10 may be secured to bone 2using non-locking fastener 40, for example. The shaft portion 44 of thefastener 40 may be driven into bone fragment 2. As depicted in FIGS.27A-27C, by driving the non-locking fastener 40 into the bone 2, theplate 10 is able to move laterally, resulting in compression of the bonefracture 4. The DCP slot 20I may be elongated with a ramp 25 milled intothe top surface 16 of the plate 10. The ramp 25 may span along theentire upper perimeter of the elongated slot 20I. An upper portion ofthe hole 20I may be tapered 28, for example, to form the ramp 25 or aportion thereof, a lower portion of hole 20I may further be tapered 29,and at the intersection between the upper tapered portion 28 and thelower tapered portion 29 a narrowed central portion may be configured toreceive the head portion 42 of the non-locking fastener 40. As shown,the narrowed central portion may be downwardly curved such that the headportion 42 of the fastener 40 may be urged into the center of the slot20I as the fastener 40 is secured further to the bone 2. Thus, as bestseen in FIG. 27C, the fastener 40 is seated securely in the center ofthe slot 20I, thereby resulting in dynamic compression of the fracture4.

FIGS. 28A-28E depict an embodiment of a plate 10 with a stacked hole 20Jconfigured to receive a plurality of alternative screw offerings. Thestacked holes 20J allow multiple screw options to be used in each holelocation. In this embodiment, the hole 20J may be comprised of a conicalchamfer 28 over top of a textured portion 26, for example, in the formof a conically threaded hole. The bottom of the hole 20J includes anadditional conical chamfer 29 to allow for variable trajectories of thenon-locking screws 40. The bottom conical chamfer 29 may be greater indiameter than the upper conical chamfer 28. The textured portion 26, orconically threaded hole, may be positioned closer to the top surface 16of the plate 10, for example, such that the bottom conical chamfer 29has a greater surface area than the upper conical chamfer 28.

As best seen in FIGS. 28A-28C, a plurality of screw offerings iscompatible with this hole 20J. For example, non-locking fasteners 40 andlocking fasteners 30 may be used in hole 20J. FIG. 28A shows 3.5 mmnon-locking screws and 4.0 mm cancellous bone screws in stacked hole20J. FIG. 28B shows a 2.5 mm non-locking screw. Each of the non-lockingscrews are configured to interface with the top chamfer 28 of the holeas shown in FIGS. 28A and 28B, respectively. Locking fasteners 30 arealso configured to interface with the conical threads of the hole 20J.As shown in FIG. 28C, 3.5 mm locking screws engage with the threadedhole portion of the stacked hole 20J. In other words, the threaded outerportion of the head portion 32 of the locking fastener 30 is configuredto thread to the corresponding conical threads of the textured portion26, thereby locking the fastener 30 to the plate 10.

FIGS. 29A-29J depict alternative embodiments of plate offerings suitablefor fixation of fractures and fragments in diaphyseal and metaphysealbone. For example, FIG. 29A depicts one embodiment of a 3.5 mm straightplate 10 with a combination of DCP slots 20I and stacked holes 20J. FIG.29B depicts a straight plate 10 with only DCP slots 20I positioned alongthe central longitudinal axis A of the plate 10. FIG. 29F shows anembodiment of a straight plate 10 with two central DCP slots 20I andstacked holes 20J at either end of the plate 10. The plate 10 may have abody that extends from a first end 12 to a second end 14 along centrallongitudinal axis A. The plate 10 includes a top surface 16 and anopposite, bottom surface 18 configured to contact adjacent bone. The topand bottom surfaces 16, 18 are connected by opposite side surfacesextending from the first to second ends 12, 14 of the plate 10. Althoughthe plate 10 is shown having a generally longitudinal body, it will beappreciated that any suitable shape and contouring of the plate 10 maybe provided depending on the location and type of fracture to be plated.

The plate 10 may comprise any suitable number and type of openings 20I,20J in any suitable configuration. These openings 20I, 20J allowsurgeons more flexibility for fastener placement, based on preference,anatomy, and fracture location. Surgeons may have differing opinions asto whether non-locking or locking screws 30, 40 (or some combination ofthe two) should be used. Further, complexity of fracture location andshape makes having as many locations for fasteners 30, 40 as possiblenecessary. This design offers surgeons a versatile method to achievehigher accuracy in placement of locking and/or non-locking screws 30,40.

The plate 10 may have one or more additional features. For example, theplate 10 may include one or more through holes 50 extending through theplate 10. For example, holes 50 may extend from the top surface 16 tothe bottom surface 18 of the plate 10. These holes 50 may be configuredto receive k-wires, for example, k-wire 51 shown in FIG. 29F. In theembodiments shown, k-wire holes 50 are provided along the centrallongitudinal axis A of the plate 10 alternating between each of therespective fastener openings 20I, 20J. Although it will be appreciatedthat any number and location of holes 50 may be provided for receivingk-wires. The k-wire holes 50 offer an additional point of fixation forthe plate 10. Driving a k-wire 51 through the appropriate hole in theplate 10 allows the plate 10 to be held on the bone while adjacent bonescrews 30, 40 can be inserted.

The plate 10 may also include one or more tapers or reliefs to minimizecontact of the plate 10 with the bone and preserve the anatomy. Theplate 10 may include one or more tapered ends 12, 14. The tapered ends12, 14 of the plate 10 may be configured to provide sub-muscularinsertion during minimally invasive procedures. The reliefs may also bein the form of one or more conical cuts 52 along the bottom surface 18of the plate 10. The conical cuts 52 may be positioned on either side ofthe k-wire holes 50 and extend outward towards the side surfaces of theplate 10. Each conical cut 52 may include a narrowed portion proximateto the k-wire hole 50 (e.g., along the central longitudinal axis A ofthe plate 10) and a widened portion proximate to the outer sidesurfaces. The limited contact undercuts 52 may minimize the platecontact with the bony anatomy in an effort to preserve the blood supplyto the bone and the surrounding soft tissues.

Referring to FIGS. 29G-J, each of the straight plates 10 illustratedtherein have beveled ends 12, 14, with both the top and bottom surfaces16, 18 having sloped portions 17, 19 to the tip of the respective end12, 14. As in the previous embodiment, the beveled ends 12, 14 of theplate 10 may be configured to provide sub-muscular insertion duringminimally invasive procedures. Additionally, each of plates 10 has ascalloped central portion 21 on the underside 18 of the plate 10. Thescalloped central portion 21 extends substantially the length of theplate 10 and acts to limit contact between the plate 10 and the bone topreserve the anatomy.

The straight plates 10 illustrated in FIGS. 29G and 29H each have aplurality of stacked holes 20J alternating with k-wire holes 50. Theplate 10 illustrated in FIG. 29J has a plurality of combination holes 20with overlapping locking holes 22 and dynamic holes 24. In at least oneembodiment, the plates 10 include either all stacked holes 20J, alllocking holes 22, all DCP slots 20I, all combination holes 20, or acombination of stacked holes 20J and DCP slots 20I. Additionally, in atleast one embodiment, all of the holes of the straight plate 10 have thesame diameter such that they may all be utilized with screws, whetherlocking screws 30, non-locking screws 40 or self-drilling screws 70, allhaving the same diameter. While straight plates 10 having specific holecombinations and diameters are described, the disclosure is not limitedto such, and the straight plates 10 may have any desired combination ofthe various holes described herein in any combination of diameters.

Turning now to FIGS. 30A-30I, reconstruction (recon) plates 10 may beoffered in a variety of lengths along with a variety of hole options.The reconstruction plate 10 includes a plurality of side relief cuts 72along the length of the plate 10, which allow the plate 10 to be bent,for example, in three dimensions. The side relief cuts 72 may be in theform of one or more curves having a widened portion along the sides ofthe plate 10 and a narrowed portion towards the center of the plate 10.The side relief cuts 72 may be positioned in line and on opposite sidesof each of the k-wire holes 50, for example. The plurality of reliefcuts 72 may form a scalloped or wavy profile along the side edges of theplate 10. As best seen in FIG. 30C, the plate 10 is able to be shaped toa multi-contour surface as a result. FIGS. 30E and 30F show anembodiment of a plate 10 with dynamic compression plating (DCP) slots orelongated openings 20I, similar to the DCP slots 20I shown in FIG. 27D.FIGS. 30D and 30G-I depict embodiments of a plate 10 with stacked holes20J, similar to stacked holes 20J in FIG. 23A or FIG. 28D.

The plate 10 illustrated in FIGS. 30H and 30I also includes beveled ends12, 14 and a scalloped underside similar to that described with respectto the plate 10 in FIGS. 29G-29J. In at least one embodiment, the plates10 include either all stacked holes 20J, all locking holes 22, all DCPslots 20I, or all combination holes 20. Additionally, in at least oneembodiment, all of the holes of the reconstruction plate 10 have thesame diameter such that they may all be utilized with screws, whetherlocking screws 30, non-locking screws 40 or self-drilling screws 70, allhaving the same diameter. While reconstruction plates 10 having specifichole combinations and diameters are described, the disclosure is notlimited to such, and the reconstruction plates 10 may have any desiredcombination of the various holes described herein in any combination ofdiameters.

FIGS. 31A-31G provide embodiments of T-plates 10, which may be availablein a variety of lengths along with a variety of hole options. TheT-plates 10 have a body with a substantially “T” shaped profile. TheT-plates 10 have an elongate portion extending along the longitudinalaxis A of the plate 10 from the first end 12 of the body and atransverse cross-portion at the second end 14 of the body. Thetransverse cross-portion may include one or more wings or extensions 80extending from the elongate portion of the plate 10. The extensions 80may each be perpendicular to or at an angle slightly greater than 90°relative to the longitudinal axis A of the plate 10. The “T” shapedprofile provides a greater screw density and is configured to capturefractures most often located near periarticular surfaces.

FIG. 31A depicts a T-plate 10 with a DCP slot 20I flanked on either sideby stacked holes 20J on the elongate portion of the plate 10. Thecross-portion also includes stacked holes 20J offset from one another. Afirst stacked hole 20J may be in line with the longitudinal axis A ofthe plate. A second stacked hole 20J may be positioned in the firstextension 80, and a third stacked hole 20J may be positioned in thesecond extension 80. FIG. 31B depicts another embodiment of the T-plate10 with the same configuration as FIG. 31A having the non-locking holes20L substituted for each of the stacked holes 20J. FIGS. 31D-31E show anon-locking hole 20L in the form of a cylindrical hole with a topchamfer 28 configured to be compatible with non-locking fasteners 40,including the 2.5 mm and 3.5 mm non-locking screws and the 4.0 mmcancellous screw. The chamfer or tapered portion 28 narrows towards thebottom of the hole 20L. These non-locking holes 20L may be substitutefor any of the other slots or holes 20I, 20J in the plate 10.

The plate 10 illustrated in FIGS. 31F and 31G also includes a beveledend 12 and a scalloped underside similar to that described with respectto the plate 10 in FIGS. 29G-29J. In at least one embodiment, theT-plate 10 includes either all stacked holes 20J, all locking holes 22,a combination of stacked holes 20J and DCP slots 20I, or a combinationof stacked holes 20J and combination holes 20. Additionally, in at leastone embodiment, all of the holes of the T-plate 10 have the samediameter such that they may all be utilized with screws, whether lockingscrews 30, non-locking screws 40 or self-drilling screws 70, all havingthe same diameter. While T-plates 10 having specific hole combinationsand diameters are described, the disclosure is not limited to such, andthe T-plates 10 may have any desired combination of the various holesdescribed herein in any combination of diameters.

FIGS. 32A-32B provide embodiments of Y-plates 10, which may be availablein a variety of lengths along with a variety of hole options. TheY-plates 10 have a body with a substantially “Y” shaped profile. TheY-plates 10 have an elongate portion extending along the longitudinalaxis A of the plate 10 from the first end 12 of the body and a pair ofdiverging wings or extensions extending from the second end 14 of thebody. The extensions 80 are each at an acute angle relative to thelongitudinal axis A of the plate 10. The “Y” shaped profile provides agreater screw density and is configured to capture fractures most oftenlocated near periarticular surfaces.

The plate 10 illustrated in FIGS. 32A and 32B also includes a beveledend 12 and a scalloped underside similar to that described with respectto the plate 10 in FIGS. 29G-29J. The plate 10 may also include k-wireholes 50. In at least one embodiment, the Y-plate 10 includes either allstacked holes 20J, all locking holes 22, a combination of stacked holes20J and DCP slots 20I, or a combination of stacked holes 20J andcombination holes 20. Additionally, in at least one embodiment, all ofthe holes of the Y-plate 10 have the same diameter such that they mayall be utilized with screws, whether locking screws 30, non-lockingscrews 40 or self-drilling screws 70, all having the same diameter.While Y-plates 10 having specific hole combinations and diameters aredescribed, the disclosure is not limited to such, and the Y-plates 10may have any desired combination of the various holes described hereinin any combination of diameters.

FIGS. 33A-33B provide embodiments of condylar plates 10, which may beavailable in a variety of lengths along with a variety of hole options.The condylar plates 10 have an elongate portion extending along thelongitudinal axis A of the plate 10 from the first end 12 of the bodyand a pair of ears 84 extending from the second end 14 of the body. Theears 84 are each at slight angle relative to the longitudinal axis A ofthe plate 10, however, each extends proximate to the longitudinal axis Asuch that there is a space less than the width of the body. Theconfiguration provides for greater contouring of the end 14.

The plate 10 illustrated in FIGS. 33A and 33B also includes a beveledend 12 and a scalloped underside similar to that described with respectto the plate 10 in FIGS. 29G-29J. The plate 10 may also include k-wireholes 50. In at least one embodiment, the condylar plate 10 includeseither all stacked holes 20J, all locking holes 22, a combination ofstacked holes 20J and DCP slots 20I, or a combination of stacked holes20J and combination holes 20. Additionally, in at least one embodiment,all of the holes of the condylar plate 10 have the same diameter suchthat they may all be utilized with screws, whether locking screws 30,non-locking screws 40 or self-drilling screws 70, all having the samediameter. While condylar plates 10 having specific hole combinations anddiameters are described, the disclosure is not limited to such, and thecondylar plates 10 may have any desired combination of the various holesdescribed herein in any combination of diameters.

FIGS. 34A-34B provide embodiments of X-plates 10, which may be availablein a variety of lengths along with a variety of hole options. TheX-plates 10 have a body with an elongate portion extending along thelongitudinal axis A of the plate 10 from the first end 12 of the bodyand a clustered 5-hole head at the second end 14 of the body. Theclustered head is defined by four extensions 80 extending from the end14 of the body in an X configuration. The “X” shaped profile provides agreater screw density and is configured to capture fractures most oftenlocated near periarticular surfaces.

The plate 10 illustrated in FIGS. 34A and 34B also includes a beveledend 12 and a scalloped underside similar to that described with respectto the plate 10 in FIGS. 29G-29J. The plate 10 may also include k-wireholes 50. In at least one embodiment, the X-plate 10 includes either allstacked holes 20J, all locking holes 22, a combination of stacked holes20J and DCP slots 20I, or a combination of stacked holes 20J andcombination holes 20. Additionally, in at least one embodiment, all ofthe holes of the X-plate 10 have the same diameter such that they mayall be utilized with screws, whether locking screws 30, non-lockingscrews 40 or self-drilling screws 70, all having the same diameter.While X-plates 10 having specific hole combinations and diameters aredescribed, the disclosure is not limited to such, and the X-plates 10may have any desired combination of the various holes described hereinin any combination of diameters.

FIGS. 35A-35B provide embodiments of cluster plates 10, which may beavailable in a variety of lengths along with a variety of hole options.The cluster plates 10 have a body with an elongate portion extendingalong the longitudinal axis A of the plate 10 from the first end 12 ofthe body and a clustered mesh head 90 at the second end 14 of the body.The plate 10 includes a beveled end 12 and a scalloped underside similarto that described with respect to the plate 10 in FIGS. 29G-29J. Theplate 10 may also include k-wire holes 50. The elongate body providesthe strength of the straight plates described above while the mesh head90 allows for significant customization.

The mesh head 90 is defined by a plurality of holes 20, in theillustrated embodiment stacked holes 20J, each with a rim 92 thereabout.The rims 92 of adjacent holes 20 are interconnected to one another viabridge portions 94 with through spaces 96 also provided between groupsof holes 20. The bridge portions 94 are preferably thinner than the rims92. The rims 92 preferably have a thickness equal to or less than thethickness of the elongate body. The thinner configuration of the bridgeportions 94 along with the through spaces 96 allow the mesh head 90 tobe easily contoured. Additionally, the mesh head 90 may be cut along thebridge portions 94 to shape the mesh head 90 to achieve a desired shapeor size. The illustrated mesh head 90 has a 3×5 hole arrangementdefining a rectangular configuration, however, the disclosure is notlimited to such. The mesh head 90 may have various numbers of holes 20which may be arranged in various configurations including, for example,square, rectangular or round (similar to mesh plate 100 illustrated inFIG. 36A).

In at least one embodiment, the cluster plate 10 includes either allstacked holes 20J, all locking holes 22, a combination of stacked holes20J and DCP slots 20I, or a combination of stacked holes 20J andcombination holes 20. Additionally, in at least one embodiment, all ofthe holes of the cluster plate 10 have the same diameter such that theymay all be utilized with screws, whether locking screws 30, non-lockingscrews 40 or self-drilling screws 70, all having the same diameter.While cluster plates 10 having specific hole combinations and diametersare described, the disclosure is not limited to such, and the clusterplates 10 may have any desired combination of the various holesdescribed herein in any combination of diameters.

FIGS. 36A-36B provide embodiments of mesh plates 100, which may beavailable in a variety of sizes along with a variety of hole options.The mesh plates 100 do not include an elongate body but instead includeonly a clustered mesh of holes 20. Similar to the mesh head 90, the meshplate 100 is defined by a plurality of holes 20, in the illustratedembodiment stacked holes 20J, each with a rim 102 thereabout. The rims102 of adjacent holes 20 are interconnected to one another via bridgeportions 104 with through spaces 106 also provided between groups ofholes 20. The bridge portions 104 are preferably thinner than the rims102. The thinner configuration of the bridge portions 104 along with thethrough spaces 106 allow the mesh plate 100 to be easily contoured.Additionally, the mesh plate 100 may be cut along the bridge portions104 to shape the mesh plate 100 to achieve a desired shape or size. Inthe embodiment of FIG. 36A, the mesh plate 100 has a circularconfiguration with a central hole 20 and two bands of holes 20thereabout. The bridge portions 104 interconnect the rings 102 withineach band and also interconnect the bands to each other and with thering 102 of the central hole 20. In the embodiment illustrated in FIG.36B, the mesh plate 100 has a 10×10 hole arrangement defining a squareconfiguration. The mesh plate 100 may have various numbers of holes 20which may be arranged in various configurations including, for example,square, rectangular or round.

In at least one embodiment, the mesh plate 100 includes either allstacked holes 20J, all locking holes 22, or all non-locking holes 24.Additionally, in at least one embodiment, all of the holes of the meshplate 100 have the same diameter such that they may all be utilized withscrews, whether locking screws 30, non-locking screws 40 orself-drilling screws 70, all having the same diameter. While mesh plates100 having specific hole combinations and diameters are described, thedisclosure is not limited to such, and the mesh plates 100 may have anydesired combination of the various holes described herein in anycombination of diameters.

FIGS. 37A-37D relate to cloverleaf plates 10. The cloverleaf plates 10have a three-pronged plate head profile. The cloverleaf plates 10 havean elongate portion extending along the longitudinal axis A of the plate10 from the first end 12 of the body and one or more wings or extensions80 extending from the elongate portion of the plate 10. As shown, thewings or extensions 80 may include three extensions 80; namely, a firstextension 80 extending in along the longitudinal axis A of the plate 10,a second extension 80 extending at a first angle relative to thelongitudinal axis A of the plate 10, and a third extension 80 extendingat a second angle, mirroring the first angle, relative to thelongitudinal axis A of the plate 10. These plates 10 are also availablein a variety of lengths along with a variety of hole options. Thecloverleaf plate 10 may be configured with a three-pronged plate headprofile to capture fractures most often located near periarticularsurfaces.

FIG. 37A depicts a cloverleaf plate 10 with a plurality of stacked holes20J positioned along the elongate portion of the plate 10. As shown, theelongate portion of the plate 10 may include a raised portion 82, forexample, with a greater thickness than the remainder of the plate 10. Inother words, the extensions 80 may have a narrower or thinner thicknessas compared to the raised portion 82 of the plate 10. The firstextensions 80 may include a DCP slot 20I and two stacked holes 20J alongthe longitudinal axis A of the plate 10. Two additional stacked holes20J may be positioned in the second extension 80, and two additionalstacked holes 20J may be positioned in the third extension 80. FIG. 37Bdepicts another embodiment of the cloverleaf plate 10 with the sameconfiguration as FIG. 37A but having the non-locking holes 20L replacingeach of the stacked holes 20J. The cloverleaf plates 10 comprise astreamlined offering to treat a vast array of fracture patterns invarious anatomical areas. The plate geometry is simplified by providinglocking screw holes which accept locking screws at monoaxialtrajectories as well as non-locking screws.

In at least one embodiment, the system includes a variety ofself-tapping and self-drilling screws offered in stainless steel,titanium alloy, and cobalt chrome. An illustrative system may include,for example, 1.5 mm non-locking screws, locking screws, andself-drilling screws (6 mm-24 mm), 2.0 mm non-locking screws, lockingscrews, and self-drilling screws (6-40 mm), and 2.5 mm non-lockingscrews, locking screws, and self-drilling screws (6-80 mm).

With reference to FIGS. 38A and 38B, an alternative plate 10 having aT-shaped design is shown. The T-plate 10 has a similar design to theT-plate shown in FIGS. 31F and 31G, but has a greater thickness alongthe length of the plate 10, and a shaft similar to the straight plateshown in FIG. 29G (e.g., without side relief cuts) for greater strengthand rigidity. The plate 10 extends from first end 12 to second end 14where extensions 80 extend in opposite directions creating asubstantially T-shaped plate 10. A plurality of holes 20 are providedalong the length of the plate 10 and within each of the extensions 80.

The holes 20 along the shaft of the plate 10 may be substantiallyaligned along the longitudinal axis A of the plate 10. The holes 20 inthe extensions 80 may also be generally aligned along a common axis,perpendicular to the longitudinal axis A of the plate 10. The hole 20near the second end 14 may be separated a distance from the nextrespective hole 20 along the length of the plate 10. At the intersectionwhere the extensions 80 meet the shaft of the plate 10, one or moreindentations 86 may be provided (for example, along the edges of theplate 10) such that the width of the plate 10 is narrowed relative tothe width at the respective holes 20 and/or the overall width of theextensions 80. The narrowing may permit bending or contouring of theextensions 80 relative to the longitudinal axis A of the plate 10. Theholes 20 provided along the plate 10 may include polyaxial holes,locking holes, non-locking holes, dynamic compression slots, or any ofthe holes described herein, and any combination thereof. The plate 10may also include k-wire holes 50 and relief undercuts or conical cuts52, for example, as shown and described for the plates in FIGS. 29A-29J.

The plates 10 may be available in different size and style optionsdepending on the style of the holes 20 including polyaxial holes,locking holes, non-locking holes, dynamic compression slots, and anycombination thereof. The T-Plates 10 provide for an optimized T-shape,with a 3-hole head design, for example, to provide enhanced screwdensity, strength and rigidity.

Turning now to FIGS. 39A and 39B, a tine plate 10 is shown. The tineplate 10 has a similar design to the condylar plate 10 shown in FIGS.33A-33B, with a 2-hole ear-shaped head for enhanced contouring. The tineplate 10 has an elongate shaft portion extending along the longitudinalaxis A of the plate 10 from the first end 12 of the body and a pair ofears 84 extending from the second end 14 of the body. The ears 84 aredivided by a groove 88 separating the ears 84 and respective holes 20therein. The groove 88 may extend along the longitudinal axis A of theplate 10. The groove 88 may extend a distance from the second end 14greater than a distance of the holes 20 within the ears 84 from thesecond end 14. In other words, the groove 88 may be deeper than a radiusof the screw holes 20 in the first and second ears 84. The groove 88 mayalso be narrow but expand in width proximate end 14. The groove 88 mayhave a first width proximate the elongate body and a second width,greater than the first width, proximate the first and second tines 98.As evident in FIG. 39A, the edges of the plate 10 may be contoured inthese areas to mimic the radius of the holes 20.

The ears 84 terminate as sharp tines or hooks 98 on each head 84,thereby providing for two extra points of distal bone fixation. Thehooks 98 may terminate as sharpened points. The hooks 98 may be bent atan angle relative to the remainder of the plate 10 and ears 84. Forexample, the hooks 98 may be provided at 90° relative the ears 84. Thehooks 98 may also be provided at an angle less than 90° such that thetips of the hooks 98 are pointed back towards the first end 12 of theplate 10. Similar to the other embodiments described herein, the tineplate 10 may include holes 20, k-wire holes 50, and side relief cuts 72,thereby providing one or more scalloped edges along the length of theshaft of the plate 10. Narrowed portions of the scalloped edges maycoincide with locations of the k-wire holes, for example. These tineplates 10 may be provided with different sizes and options of holestyles, e.g., polyaxial holes, locking holes, non-locking holes dynamiccompression slots, and a combination of these.

The holes 20 in the ears 84 near the second end 14 may be separated adistance from the next respective hole 20 along the length of the plate10. At the intersections where the ears 84 meet the shaft of the plate10, one or more indentations 86 may be provided such that the width ofthe plate 10 is narrowed relative to the width at the respective holes20 and/or the overall width of the ears 84. The narrowing may permitbending or contouring of the ears 84 relative to the plate 10. The2-hole ear-shaped tine plate 10 may allow for enhanced contouring andthe angled sharp hooks 98 may allow for extra points of distal bonefixation.

Turning now to FIGS. 40A-40H, alternative configurations are shown forthe plates 10 described herein, with the circles signifying the holes 20and the line segments representing plate portions between the holes 20.It will be appreciated that the holes 20 may include any of the holetypes described herein and the plates 10 may incorporate other featuresdescribed herein, such as k-wire holes, scalloped or straight edges,undercuts, etc. In FIG. 40A, the plate features a double-Y head design.A plurality of extensions 80 are provided as two extensions 80 on eachrespective side of the plate 10. The upper and lower extensions 80 arealigned in parallel, and angled toward end 14, thereby providing adouble Y-shaped configuration. FIG. 40B shows extensions 80 with agenerally sideways k-shaped configuration. The upper extensions 80angled toward end 14, thereby forming a generally y-shaped end. Thelower extensions 80 extending generally perpendicular to thelongitudinal axis A of the shaft of the plate 10 forming a generallyt-shaped configuration. The extensions 80 may extend out at differentangles from the outermost screw hole 20 for additional head fixation.FIG. 40C is similar to FIG. 40B with a generally sideways k-shape, butthe perpendicular extensions 80 are moved to extend from the plateportion instead of from a hole segment. FIG. 40D is a plate thatincludes two angled extensions 80 positioned along the plate 10 (e.g.,on the second opening 20) to create a 3-pronged head portion. The twoindependent y-shaped arms 80 extend from the second outermost screw hole20, with an additional shaft hole 20 forming a third independent arm.

FIG. 40E creates an I-like configuration or sideways H-likeconfiguration with the upper and lower extensions 80 each extendinggenerally perpendicularly from the shaft portion and remaining parallelto one another. FIG. 40F provides a t-like or cross-shaped configurationwith only first and second extensions 80 extending from plate 10 (e.g.,from the second opening 20) generally perpendicular to the longitudinalaxis of the plate 10. FIG. 40G features a diamond-like head design withupper extensions 80 generally angled downward towards end 12 and lowerextensions 80 generally angled upward towards end 14 such that thedistal ends of the upper and lower extensions 80 are closer to oneanother relative to the proximal portions attached to the shaft portionof the plate 10. The outermost and second outermost screw holes may eachhave two independent arms 80 extending outward forming a diamond shapedhead. FIG. 40H is similar to FIG. 40D or FIG. 40F except that theextensions 80 are generally angled downward toward end 12 to form aninverse Y-shaped design. Although a number of variations are shown, itwill be appreciated that the extensions 80 could connected at differentlocations along the plate 10, could be angled differently, could includemore or less extensions 80, or could be otherwise configured.

Turning now to FIGS. 41A and 41B, an alternative trauma plate 10 isprovided, which may be suitable, for example, for securing smaller orminiature bone fragments. The plate 10 extends from a distal, first end12 to a proximal, second end 14 along longitudinal axis A. The plate 10may include an elongate body and the second end 14 may have an enlargedhead portion 90 relative to the remainder of the plate 10. Similar tothe other embodiments described herein, the plate 10 may include screwor fastener holes 20 (including polyaxial holes, locking holes,non-locking holes, etc.), k-wire holes 50, and side relief cuts 72. Theelongate body may also include a sliding slot 58 in the form of anelongate opening having a length greater than its width configured toreceive a fastener or screw to allow for positioning of the plate 10during implantation. The sides of the slot 58 may be provided with oneor more markings to indicate the amount of movement and/or position ofthe plate 10.

In the embodiment shown, the plate 10 includes two polyaxial openings 20near the end 12 and two polyaxial openings 20 near the enlarged head 90,which are all aligned along the center longitudinal axis A of the plate10. The elongate sliding slot 58 may be positioned between these tworespective pairs of openings 20 along the axis A. The enlarged head 90also include a plurality of openings 20. The openings 20 may be arrangedsuch that three holes 20 are positioned along one axis to one side ofthe axis A and two holes 20 are positioned along another axis to theopposite side of the axis A. The three holes 20 and two holes 20 mayalso be offset relative to one another. The head 90 may be contouredwith the relief cuts 72 such that the outer, edge surface of the plate10 mimics the configurations of the openings 20. It will be appreciatedthat other configurations, numbers and types of openings may be providedto maximize fixation of the fractures.

The illustrated plates 10, 100 provide a comprehensive offering to treata vast array of fracture patterns in various anatomical areas of varyingsizes. The plates 10, 100 are capable of being used for both definitive,permanent fixation, as well as temporary or supplemental fixation inaccordance with other systems. The specific plate styles afford theability to accommodate multiple fracture patterns. The cluster platesaccommodate optimal contouring in the head portion, while stillmaintaining strength and stability in the shaft portion of the plate byincorporating variable thickness between the two. The mesh plates arecapable of being cut and contoured to accommodate an extremely expandedrange of sizes, shapes, and contours. The large range of screw and platesizes can accommodate multiple anatomies and anatomical regions.

Although the invention has been described in detail and with referenceto specific embodiments, it will be apparent to one skilled in the artthat various changes and modifications can be made without departingfrom the spirit and scope of the invention. Thus, it is intended thatthe invention covers the modifications and variations of this inventionprovided they come within the scope of the appended claims and theirequivalents. It is expressly intended, for example, that all rangesbroadly recited in this document include within their scope all narrowerranges which fall within the broader ranges. It is also intended thatthe components of the various devices disclosed above may be combined ormodified in any suitable configuration.

What is claimed is:
 1. A bone stabilization plate comprising: anelongate body extending from a first end to a second end along a centrallongitudinal axis, the elongate body defining a plurality of screw holestherethrough and a k-wire hole disposed between each of the screw holesof the elongate body, wherein the diameter of each of the k-wire holesis smaller than the diameter of each of the screw holes; first andsecond ears extending laterally from the second end of the elongate bodyrelative to the central longitudinal axis such that each ear islaterally spaced from the central longitudinal axis, each of the firstand second ears defining a screw hole therethrough; and a first tineextending from the first ear and a second tine extending from the secondear, the first and second tines each terminating at a sharp point, agroove laterally separating the first and second ears from each other,the groove longitudinally extending on the central longitudinal axis adistance from the second end toward the first end such that the grooveextends to a position which is closer to the first end than the screwholes of the ears.
 2. The bone stabilization plate of claim 1, whereinthe first and second tines are bent at an angle relative to thelongitudinal axis of the elongate body.
 3. The bone stabilization plateof claim 1, wherein the first and second tines are bent at 90° relativeto the longitudinal axis of the elongate body.
 4. The bone stabilizationplate of claim 1, wherein the groove is deeper than a radius of thescrew holes in the first and second ears.
 5. The bone stabilizationplate of claim 1, wherein the groove has a first width proximate theelongate body and a second width, greater than the first width,proximate the first and second tines.
 6. The bone stabilization plate ofclaim 1, wherein the elongate body has scalloped edges.
 7. The bonestabilization plate of claim 6, wherein narrowed portions of thescalloped edges coincide with locations of the k-wire holes.
 8. The bonestabilization plate of claim 1, wherein one or more indentations areprovided where the first and second ears meet the elongate body suchthat a width of the plate is narrowed relative to a width of the firstand second ears at the respective screw holes.
 9. The bone stabilizationplate of claim 1, wherein the screw holes are selected from a groupconsisting of locking holes, non-locking holes, polyaxial holes, dynamiccompression slots, combination locking and non-locking holes, andstacked holes.
 10. A bone stabilization plate comprising: an elongatebody extending from a first end to a second end along a centrallongitudinal axis, the elongate body defining a plurality of screw holestherethrough and a k-wire hole disposed between each of the screw holesof the elongate body, wherein the diameter of each of the k-wire holesis smaller than the diameter of each of the screw holes; first andsecond ears extending laterally away from the central longitudinal axisand from the second end of the elongate body, the first and second earsseparated by a groove extending longitudinally on the centrallongitudinal axis; and a first tine extending from the first ear and asecond tine extending from the second ear, wherein the groove has afirst width proximate the elongate body and a second width proximate thefirst and second tines, the second width is greater than the firstwidth, wherein each of the first and second ears defining a screw holetherethrough, wherein the groove longitudinally extends along thecentral longitudinal axis a distance from the second end toward thefirst end such that the groove extends to a position which is closer tothe first end than the screw holes of the ears, and wherein the firsttine and the second tine each narrow to terminate at a sharp point. 11.The bone stabilization plate of claim 10, wherein the first and secondtines are bent at an angle relative to the longitudinal axis of theelongate body.
 12. The bone stabilization plate of claim 10, wherein thefirst and second tines are bent at 90° relative to the longitudinal axisof the elongate body.
 13. The bone stabilization plate of claim 10,wherein the groove is deeper than a radius of the screw holes in thefirst and second ears.
 14. The bone stabilization plate of claim 10,wherein the elongate body has scalloped edges.
 15. The bonestabilization plate of claim 14, wherein narrowed portions of thescalloped edges coincide with locations of the k-wire holes.
 16. Thebone stabilization plate of claim 10, wherein one or more indentationsare provided where the first and second ears meet the elongate body suchthat a width of the plate is narrowed relative to a width of the firstand second ears at the respective screw holes.
 17. The bonestabilization plate of claim 10, wherein the screw holes are selectedfrom a group consisting of locking holes, non-locking holes, polyaxialholes, dynamic compression slots, combination locking and non-lockingholes, and stacked holes.
 18. A bone stabilization plate comprising: anelongate body extending from a first end to a second end along a centrallongitudinal axis, the elongate body defining a plurality of screw holestherethrough and a k-wire hole disposed between each of the screw holesof the elongate body, wherein the diameter of each of the k-wire holesis smaller than the diameter of each of the screw holes, the elongatebody having scalloped edges with narrowed portions between the pluralityof screw holes, wherein the narrowed portions of the scalloped edgescoincide with locations of the k-wire holes; first and second earsextending from the second end of the elongate body, the first and secondears being separated by a groove extending longitudinally on the centrallongitudinal axis, each of the first and second ears extending laterallyaway from the central longitudinal axis and each of the first and secondears defining a screw hole therethrough; and a first tine extending fromthe first ear and a second tine extending from the second ear, the firstand second tines each terminating at a sharp point, wherein the groovehas a first width proximate the elongate body and a second width,greater than the first width, proximate the first and second tines,wherein the groove longitudinally extends along the central longitudinalaxis a distance from the second end toward the first end such that thegroove extends to a position which is closer to the first end than thescrew holes of the ears.